Evaluación de la utilidad de la vitamina D como predictor de mortalidad en pacientes con COVID-19 / Evaluation of the usefulness of vitamin D as a predictor of mortality in patients with COVID-19

Resumen Introducción: Una de las funciones de la vitamina D es regular la respuesta inflamatoria del epitelio respiratorio; por ello, la deficiencia de esa vitamina en el contexto de COVID-19 podría constituir un biomarcador preditivo del desenlace de COVID-19. Objetivo: Evaluar la utilidad de la vitamina D para predecir la mortalidad en pacientes con COVID-19. Métodos: Estudio observacional y retrospectivo en el que se incluyeron 154 pacientes con diagnóstico de COVID-19, de los cuales 111 sobrevivieron y 43 fallecieron. En todos se determinó la concentración de vitamina D. Resultados: Se obtuvo un valor log-rank de p < 0.032 para la supervivencia al utilizar la concentración de vitamina D como variable categórica (≤ 20 ng/mL y > 20 ng/mL). Mediante análisis proporcional de Cox se encontró que la edad y concentración de vitamina D mostraron ser factores de riesgo asociados a la mortalidad en pacientes con COVID-19 (edad: HR = 1.036, IC 95 % = 1.016-1.058, p < 0.001; vitamina D: HR ≤ 20 ng/mL y > 20 ng/mL = 0.478, IC 95 % = 0.237-0.966, p < 0.040). Conclusión: La edad y la concentración de vitamina D constituyeron factores predictivos de mortalidad en pacientes infectados por COVID-19.

Abstract Introduction: One of the functions of vitamin D is to regulate respiratory epithelium inflammatory response; therefore, deficiency of this vitamin in the context of COVID-19 could constitute a predictive biomarker of the disease outcome. Objective: To evaluate the usefulness of vitamin D for predicting mortality in patients with COVID-19. Methods: Observational, retrospective study in which 154 patients diagnosed with COVID-19 were included, out of whom 111 survived and 43 died. Vitamin D concentration was determined in all of them. Results: A log-rank p-value < 0.032 was obtained for survival when vitamin D concentration was used as a categorical variable (≤ 20 ng/mL and > 20 ng/mL). On Cox proportional analysis, age and vitamin D concentration were shown to be risk factors associated with mortality in patients with COVID-19 (age: HR = 1.036, 95% CI = 1.016-1.058, p < 0.001; vitamin D: HR [≤ 20 ng/mL and > 20 ng/mL] = 0.478, 95% CI = 0.237-0.966, p < 0.040). Conclusion: Age and vitamin D concentration were predictive factors for mortality in COVID-19-infected patients.

Histopathologic alterations of gill tissue in Siluriformes and Characiformes from the Middle Tocantins River in the Brazilian Amazon / Alterações histopatológicas do tecido branquial em Siluriformes e Characiformes do médio rio Tocantins, na Amazônia brasileira

As águas do rio Tocantins têm sofrido descargas de dejetos tóxicos que ameaçam a biota aquática. Para tanto, a investigação das brânquias de peixes atua como biomonitoramento, visto que esses órgãos respondem por meio de adaptações a xenobióticos. Este trabalho teve como objetivo avaliar a ocorrência de alterações morfológicas das espécies de Psectrogaster amazonica, Pimelodina flavipinnis e Pimelodus blochii. As coletas ocorreram nas estações chuvosa e seca. As brânquias de todos os espécimes coletados foram processadas de acordo com metodologia específica para protocolo de hematoxilina e eosina. As principais alterações histológicas observadas no período chuvoso foram: hiperplasia, destacamento do epitélio filamentar, fusão parcial e total das lamelas secundárias, congestão, aneurisma e encurtamento das lamelas respiratórias. Em relação ao período seco, as principais lesões observadas foram: ruptura do epitélio, aneurisma, hiperplasia e necrose. Considerando a diversidade ictiológica do rio Tocantins, o presente estudo propiciará o conhecimento da condição das brânquias, órgão imprescindível para a saúde do peixe, e consequentemente a compreensão das implicações sobre a qualidade das águas do rio Tocantins.(AU)

Expression of mesenchymal stem cell phenotype in human nasal respiratory epithelial cells / Expresión del fenotipo de células troncales mesenquimales en células epiteliales nasales humanas

The respiratory epithelium is the first line of contact with the external hazards. Thus it can be damaged and need to be replaced to avoid healing by fibrosis. Tracheal tissue engineering is an alternative promising treatment modality. Mesenchymal stem cell markers are surface proteins, which are responsible for some of these cells unique properties. The objective of this study was to detect the mesenchymal stem cell phenotype among the human nasal respiratory epithelial cells via two immunophenotyping techniques. Respiratory epithelial cells were cultured using co-culture technique, fibroblasts was removed at confluence leaving respiratory epithelial cells, which were passage further to passage 4. Cells were evaluated for mesenchymal stem cell markers that were CD73, CD90, CD105 and the hematopoietic stem cell marker CD45 at passage 1 (P1) and passage 4 (P4) using Flow cytometry and Immunocytochemistry techniques. Respiratory epithelial cells expressed the mesenchymal stem cell markers at P1 and maintain the expression these markers until P4. Using both techniques, to compare the values of mesenchymal stem cell markers expression at P1 to P4 there was no significant difference. This study indicates that respiratory epithelial cells derived from nasal turbinate retain some of mesenchymal stem cells properties even after serial passages. Both methods of Immunophenotyping are comparable.

El epitelio respiratorio es la primera línea de contacto con los peligros externos. Por lo tanto, puede ser dañado y necesita ser reemplazado para evitar uan cicatrización por fibrosis. La ingeniería de tejidos traqueales es una modalidad de tratamiento alternativo prometedora. Los marcadores de células troncales mesenquimales son proteínas de superficie, que son responsables de algunas propiedades únicas de estas células. El objetivo fue detectar el fenotipo de células troncales mesenquimales entre las células epiteliales respiratorias nasales humanas a través de dos técnicas de inmunofenotipaje. Fueron cultivadas las células epiteliales respiratorias utilizando la técnica de co-cultivo; los fibroblastos se eliminaron en la confluencia dejando solo células epiteliales respiratorias, resultantes de los 4 pasajes. Las células fueron evaluadas para encontrar marcadores de células troncales mesenquimales mediante CD73, CD90, CD105 y el marcador de células troncales hematopoyéticas CD45 en el paso 1 (P1) y el paso 4 (P4), usando citometría de flujo y técnicas de inmunocitoquímica. Las células epiteliales respiratorias expresaron los marcadores de células troncales mesenquimales en P1 y mantuvieron la expresión de estos marcadores hasta P4. No hubo diferencias significativas en el uso de ambas técnicas al comparar los valores de los marcadores de células troncales mesenquimales expresadas desde P1 a P4. Este estudio indica que las células epiteliales respiratorias derivadas de la concha nasal retienen algunas de las propiedades de células troncales mesenquimales, incluso después de pases seriados. Ambos métodos de inmunofenotipificación son comparables.

Oral foregut cyst in the ventral tongue: a case report

An oral foregut cyst is a rare congenital choristoma lined by the respiratory and/or gastrointestinal epithelium. The exact etiology has not been fully identified, but it is thought to arise from misplaced primitive foregut. This lesion develops asymptomatically but sometimes causes difficulty in swallowing and pronunciation depending on its size. Thus, the first choice of treatment is surgical excision. Surgeons associated with head and neck pathology should include the oral foregut cyst in the differential diagnosis for ranula, dermoid cyst, thyroglossal duct cyst and lymphangioma in cases of pediatric head and neck lesions.

The Properties of Glycoconjugates in the Rat Nasal Mucosa following Inhalation of Formaldehyde / 대한해부학회지

The present study was carried out to investigate the glycoconjugate properties of the nasal mucosa in the rat after inhalation of formaldehyde. Sprague-Dawley male rats were inhalated 30 ppm formaldehyde for 3 times with 3 hours exposure. The olfactory and respiratory mucosa in the nasal mucosa were taken from the animals on 3, 6,9 days and 2, 3, 4, 5 weeks after inhalation of formaldehyde. The properties of glycoconjugate of the olfactory and respiratory mucosa were investigated using nine biotinylated lectins (PSA, UEA I, PHA-L, BSL I, PNA, MAL I, DBA, BSL II or sWGA). In experimental groups, the degenerative changes of the olfactory epithelium were observed until 3 weeks after inhalation of formaldehyde, but the respiratory epithelium was no change. In control group, the olfactory cells in the olfactory epithelium reacted with PSA, UEA I, PNA, DBA, BSL II, sWGA, and the supporting cells reacted with PSA, PHA-L, PNA, MAL I, DBA, BSL II, sWGA, and Bowman's glands reacted with all the lectins. In experimental groups, the olfactory cells reacted with UEA I, DBA, and the supporting cells reacted with PHA-L, MAL I, DBA, UEA I, and the positive reaction of Bowman's glands was increased. In control group, the goblet cells in the respiratory epithelium reacted with UEA I, MAL I, and the ciliated columnar cells reacted with PSA, UEA I, PHA-L, BSL I, DBA, BSL II, sWGA, and the septal nasal glands reacted with all the lectins except UEA I. In experimental groups, the goblet cells reacted with UEA I, MAL I and PNA. Conclusively, the olfactory mucosa was shown a lot of changes in the properties of glycoconjugates following inhalation of formaldehyde, but respiratory mucosa was shown feeble change. These results suggest that there were different sugar residues of glycoconjugate in the olfactory and respiratory mucosa following inhalation of formaldehyde, respectively.

Acción del Etanol sobre el Epitelio Nasal y Glándulas Septales de Ratas, Durante la Lactancia / Action of Ethanol on Rat Pups Nasal Epithelium and Septal Glands, During Lactation

El consumo materno de etanol durante la lactancia altera la composición de la leche, provoca la aparición de etanol y acetaldehído en la leche y agrava los efectos del etanol en las crías de ratas. De este modo, fueron estudiados los efectos del etanol, administrado a las ratas madres durante la lactancia, sobre el epitelio respiratorio y en las glándulas septales anterior y posterior de las crías lactantes con 21 días de vida postnatal. Las ratas recibieron etanol al 20% en el bebedero, ad libitum durante los 21 días que amamantaron. Los controles recibieron un volumen similar de agua sin alcohol. Las crías fueron sacrificadas en el 21 día. Las cabezas fueran cortadas frontalmente. Los cortes seriados de 6 µm de grosor fueron teñidos con hematoxilina y eosina. Fueron determinados los parámetros nucleares de los epitelios respiratorio y glandular, así como los volúmenes citoplasmático y celular, relación núcleo-citoplasma, densidades numérica y superficial y espesor del epitelio. El peso corporal medio de las crías control fue 34,9 g y en las tratadas 20,2 g. Histologicamente, el epitelio respiratorio se mostró adelgazado en el grupo tratado, constituido por células abundantes y menores, con núcleos menores. La glándula septal posterior presentó ácinos menores. En este trabajo, el etanol indujo un cuadro de hipotrofia epitelial (respiratorio y glandular), indicando una acción directa sobre las células de la mucosa nasal, además de retardar el desarrollo de las crías intoxicadas.

Maternal ingestion of ethanol during lactation alters the chemical composition of milk, results in the appearance of ethanol and acetaldehyde in milk, and exacerbates the effects of ethanol on the rat pups. So that, the effect on respiratory epithelium and anterior and posterior septal glands in 21-day-old suckling pups of ethanol treated mothers was studied. Female rats received dinking water ad libitum containing ethanol (20%) throughout the whole lactation. Control animals received a similar volume of water without ethanol. Lactent rats (21 day-old) were killed by lethal dose of anesthetic. The heads were serially sectioned (6µm thick) in a frontal plain, and stained with haematoxylin and eosin. Cell nuclear parameters were estimated, as well as cytoplasm and cell volume, nucleus-cytoplasm ratio, number and surface densities, and epithelial thickness. Mean body weight of the pups was 34.9 g for the controls and 20.2 g for the treated group. Histologically, the respiratory epithelium was thinner, with more numerous and smaller cells and small nuclei. The posterior septal glands showed smaller acini. In this paper, ethanol induced epithelial (respiratory and glandular) hypotrophy, indicating a direct action in nasal mucous cells, besides retarded development in pups.

The Effect of Phenylephrine Hydrochloride on Ciliary Beat Frequency in Nasal Respiratory Epithelium / 대한이비인후과학회지

The mucociliary system has primary defence mechanism in the respiratory tract. The effects of various drugs used clinically in the treatment of disease of the nasal cavity have not been fully elucidated. The aim of this study was to investigate the effects of alpha1 receptor agonist, phenylephrine hydrochloride on ciliary beat frequency in vitro using a video computerized analysis technique. The ciliated epithelial cells from the nasal mucosa in four volunteers were collected in a culture medium and exposed to 0.125%, 0.25%, 0.5%, 1.0%, and 2.5% phenylephrine hydrochloride solution according to 0.5 hour, 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 1 day, 2 days, 3 days, 4 days, 5 days, and 6 days. There was a significant decrease in ciliary beat frequency with exposure to 0.125% phenylephrine hydrochloride solution for 12 hours, and 0.25% phenylephrine hydrochloride solution for 8 hours(p<0.05). There were cilioinhibitory effects with concentration dependent response by phenylephrine hydrochloride solution. After substitution of the culture medium with phenylephrine hydrochloride free one showed no ciliary recovery in all groups. The results of this study suggest that phenylephrine hydrochloride may have phamacologically a cilioinhibitory effect in vitro on ciliated epithelium.

Regional Differences in Proliferative Activity of Nasal Epithelium in Rat

We investigated the active proliferation sites of epithelial cells in normal nasal mucosa by immunohistochemical staining of proliferating cell nuclear antigen (PCNA), the marker of S phase of cell cycle and active cell proliferation. The whole nasal mucosa of the ten normal Sprague-Dawley rats were processed for PCNA immunolabeling. In respiratory portion, distinctly positive reaction was seen mainly in the anterior aspect, that is, the nuclei of squamous and non-ciliated cuboidal/transitional epithelium. These types of epithelial cells are transformed to pseudostratified ciliated epithelium in the posterior direction where positive reaction became scanty. In olfactory epithelium, the nuclei immunoreactive for PCNA were distinct in some area, but absent in other adjacent areas, lacking of region-specific immunolabeling that was observed in respiratory mucosa. These results suggest that anterior portion of nasal cavity is the main proliferation zone of normal nasal respiratory epithelium as well as the main site of protective function. In contrast, the neurogenesis of the olfactory nerve cells is not site-specific, indicating that any region covered by olfactory mucosa may be the main proliferation zone.